Healthcare providers should contact their state hospital associations to learn about health insurance exchanges and what those networks will mean for hospitals and health systems, according to Leo Brideau, president and CEO of the Ascension Health Care Network, who served on a panel about state exchanges during the American Hospital Association's annual meeting in Washington.
Brideau, who has been involved in Wisconsin's state exchange process, told Modern Healthcare that he views the topic of insurance exchanges as “very complicated” and that hospitals should contact their state associations to become engaged in the process.
As part of the panel discussion—which also featured Joel Ario, director of the office of health insurance exchanges at CMS' Center for Consumer Information and Insurance Oversight, and Carolyn Scanlan, president and CEO of the Hospital & Healthsystem Association of Pennsylvania—the AHA provided attendees with a checklist of considerations for hospitals regarding the implementation of state exchanges.
“While providers are not specifically identified as stakeholders in exchange governance, hospitals need to be recognized as important stakeholders in their establishment and governance,” the guidance said. The checklist offered specific information centering on three main issues for hospitals: governance, functions of the exchange, and contracting with state agencies and vendors.
During the question-and-answer period, Ario was asked if the scope, cost and details of the federal option for exchanges would be delivered in a timely manner as states decide which option to use. “The federal exchange will be developed on the same timeline as state exchanges,” Ario said, adding that the federal exchange may include certain elements that are uniform for all states. “People are looking for a panacea,” he said, adding that the process will be more interactive.
Ario also said HHS expects to issue a notice a proposed rule on essential benefits by the fall of this year, with a final rule to follow next year. Essential benefits are those that HHS will determine must be included in all health plans. The agency will consider process recommendations from the Institute of Medicine as the agency develops the proposed rule.